1. Field of the Invention
The present invention relates to medical and surgical methods and devices for sacroiliac joint exposure, fusion, and debridement methods and the reliable restoration of nearby tissues.
2. Description of Related Art
The human body has two sacroiliac joints in the pelvis. In between them is the sacrum which supports the spine at the fifth lumbar vertebrae. So one joint is on the left and the other is close by on the right. The outside of each sacroiliac joint meets and is overlapped by an ilium on each side of the pelvis. The ilium is the uppermost and largest bone of the pelvis. All of these bones are held together by strong ligaments.
Transosseous, medial posterior and anterior exposures of the sacroiliac joint are conventional and each has its shortcomings. For example, these all can cause wide injuries in varying degrees to the soft tissues and bones adjacent to the joint that will consequently interfere with complete healing and restoration of function.
A conventional, and typical posterior technique was described this way in Canale & Beaty: Campbell's Operative Orthopaedics, 12th ed. Copyright © 2012 Mosby, An Imprint of Elsevier, Sacroiliac Joint, Posterior Approach to the Sacroiliac Joint Technique 1-74:                Make an incision along the lateral lip of the posterior third of the iliac crest to the posterior superior spine.        Deepen the dissection down to the crest, separate the lumbodorsal fascia from it, detach and reflect medially the aponeurosis of the sacrospinalis muscle together with the periosteum, and expose the posterior margin of the sacroiliac joint. This exposure is ample for extraarticular fusion.        To expose the articular surfaces of the joint for drainage or intraarticular fusion, continue the skin incision laterally and distally 5 to 8 cm from the posterior superior spine. Split the gluteus maximus muscle in line with its fibers, or incise its origin on the iliac crest, the aponeurosis of the sacrospinalis, and the sacrum, and reflect it laterally and distally to expose the posterior aspect of the ilium. Branches of the inferior gluteal nerve and artery may be present.        To expose more of the ilium, reflect the gluteus medius anterolaterally. The gluteus medius cannot be reflected very far anteriorly because of the presence of the superior gluteal nerve and artery.        With an osteotome, remove a full-thickness section of the ilium 1.5 to 2 cm wide, beginning at its posterior border between the posterior superior and posterior inferior spines and proceeding laterally and slightly cephalad for 4 to 5 cm. The inferior border of this section roughly parallels the superior border of the greater sciatic notch.        Exposure of the joint is limited by the size of the section removed.        In another conventional, but anterior approach, by Avila: with the patient supine, make a 10 to 12 cm incision 1.5 cm proximal to and parallel with the iliac crest, beginning at the anterosuperior iliac spine. Dissect distally to the iliac crest and detach the abdominal muscles from it without disturbing the origin of the gluteal muscles. Incise the periosteum and strip the iliacus muscle subperiosteally, following the medial surface of the ilium medially and slightly distally. Retract the iliacus medially and complete the stripping by hand with the gloved finger covered with gauze. Proceed as far as the lateral attachments of the anterior sacroiliac ligament; detach them and palpate the joint. To expose the anterior aspect of the joint, extend the incision further posteriorly in the intermuscular plane along the iliac crest.        
What is needed is a method for reliable exposure of the posterior inferior portion of the sacroiliac joint that minimizes injury to the surrounding ligaments and muscles. A mechanism of healing is necessary that is reliable and easily stabilized. Anatomic orientation should also be included to help the surgeon recover the correct positioning relative to the oblique sacroiliac joint complex.